Talking health: trusted health messengers and effective ways of delivering health messages for rural mothers in Southwest Ethiopia

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Summary

Background

Access to trusted health information has contribution to improve maternal and child health outcomes. However, limited research to date has explored the perceptions of communities regarding credible messenger and messaging in rural Ethiopia. Therefore, this study aimed to explore sources of trusted maternal health information and preferences for the mode of delivery of health information in Jimma Zone, Ethiopia; to inform safe motherhood implementation research project interventions.

Method

An exploratory qualitative study was conducted in three districts of Jimma Zone, southwest of Ethiopia, in 2016. Twelve focus group discussions (FGDs) and twenty-four in-depth interviews (IDIs) were conducted among purposively selected study participants. FGDs and IDIs were conducted in the local language, and digital voice recordings were transcribed into English. All transcripts were read comprehensively, and a code book was developed to guide thematic analysis. Data were analyzed using Atlas.7.0.71 software.

Result

Study Participants identified as Health Extension Workers (HEWs) and Health Development Army (HDA) as trusted health messengers. Regarding communication channels, participants primarily favored face-to-face/interpersonal communication channels, followed by mass media and traditional approaches like community conversation, traditional songs and role play.

In particular, the HEW home-to-home outreach program for health communication helped them to build trusting relationships with community members; However, HEWs felt the program was not adequately supported by the government.

Conclusion

Health knowledge transfer success depends on trusted messengers and adaptable modes. The findings of this study suggest that HEWs are a credible messenger for health messaging in rural Ethiopia, especially when using an interpersonal message delivery approach. Therefore, government initiatives should strengthen the existing health extension packages by providing in-service and refresher training to health extension workers.

Electronic supplementary material

The online version of this article (10.1186/s13690-019-0334-4) contains supplementary material, which is available to authorized users.

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Most cited references 10

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Experiences with nutrition-related information during antenatal care of pregnant women of different ethnic backgrounds residing in the area of Oslo, Norway.

Lisa Garnweidner, Kjell Sverre Pettersen, Annhild Mosdøl (2013)

to explore experiences with nutrition-related information during routine antenatal care among women of different ethnical backgrounds.

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Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project

Ronald Labonté, David Sanders, Corinne Packer … (2014)

Background The 4-year (2007–2011) Revitalizing Health for All international research program (http://www.globalhealthequity.ca/projects/proj_revitalizing/index.shtml) supported 20 research teams located in 15 low- and middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC) initiatives at their local or national levels. Teams were organized in a triad comprised of a senior researcher, a new researcher, and a ‘research user’ from government, health services, or other organizations with the authority or capacity to apply the research findings. Multiple regional and global team capacity-enhancement meetings were organized to refine methods and to discuss and assess cross-case findings. Objective Most research projects used mixed methods, incorporating analyses of qualitative data (interviews and focus groups), secondary data, and key policy and program documents. Some incorporated historical case study analyses, and a few undertook new surveys. The synthesis of findings in this report was derived through qualitative analysis of final project reports undertaken by three different reviewers. Results Evidence of comprehensiveness (defined in this research program as efforts to improve equity in access, community empowerment and participation, social and environmental health determinants, and intersectoral action) was found in many of the cases. Conclusions Despite the important contextual differences amongst the different country studies, the similarity of many of their findings, often generated using mixed methods, attests to certain transferable health systems characteristics to create and sustain CPHC practices. These include: Well-trained and supported community health workers (CHWs) able to work effectively with marginalized communities Effective mechanisms for community participation, both informal (through participation in projects and programs, and meaningful consultation) and formal (though program management structures) Co-partnership models in program and policy development (in which financial and knowledge supports from governments or institutions are provided to communities, which retain decision-making powers in program design and implementation) Support for community advocacy and engagement in health and social systems decision making These characteristics, in turn, require a political context that supports state responsibilities for redistributive health and social protection measures.

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Contraceptive knowledge, attitude and practice among rural women.

R Mustafa, Uzma Afreen, Ahmar H Hashmi (2008)

To assess the knowledge, attitude regarding family planning and the practice of contraceptives among rural women. A cross-sectional observational study. The gynaecological outpatient clinic of Fatima Hospital, Baqai Medical University, Karachi, from July to December 2005. One-hundred women between the ages 15-45, living with their husbands and coming from rural area (villages) were interviewed. Women who were pregnant, had a child younger than 2 years, or had any medical disorder were excluded. Their knowledge, attitude and practice on contraceptives were evaluated with the help of a predesigned questionnaire. The other variables used were the age of women, parity and educational status. Descriptive analysis was conducted to obtain percentages. Out of 100 interviewed women with mean age of 29.7 years, 81(81%) had some knowledge about family planning methods. The media provided information of contraceptives in 52 out of 81 (64%) women. Regarding the usage of contraceptive methods, only 53 (53%) of the respondents were using some sort of contraception. Barrier method (condoms) was in practice by 18 (33.9%) and 12 (22.6%) of women had already undergone tubal ligation. The women using injectables and intrauterine contraceptive devices were 10 (18.8%) and 7 (13.2%) respectively. Six were using oral contraceptive pills (11.3%). Positive attitude towards contraception was shown by 76 (76%) of them, while 41(41%) stated their husbands' positive attitude towards contraception. In the present study, there was a low contraceptive use among women of rural origin despite good knowledge. Motivation of couples through media and health personnel can help to achieve positive attitude of husbands for effective use of contraceptives.

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Author and article information

Contributors

Shifera Asfaw: +251945652465 , shiferaa@yahoo.com

Sudhakar Morankar: morankarsn@yahoo.com

Muluemebet Abera: mulu_abera.ts2009@yahoo.com

Abebe Mamo: +251911030949 , abema24@yahoo.com

Lakew Abebe: +251917823144 , lakewgebretsadika9@gmail.com

Nicole Bergen: nicolejbergen@gmail.com

Manisha A. Kulkarni: manisha.kulkarni@uottawa.ca

Ronald Labonté: rlabonte@uottawa.ca

Journal

Journal ID (nlm-ta): Arch Public Health

Journal ID (iso-abbrev): Arch Public Health

Title: Archives of Public Health

Publisher: BioMed Central (London )

ISSN (Print): 0778-7367

ISSN (Electronic): 2049-3258

Publication date (Electronic): 21 February 2019

Publication date PMC-release: 21 February 2019

Publication date Collection: 2019

Volume: 77

Electronic Location Identifier: 8

Affiliations

[1 ]ISNI 0000 0001 2034 9160, GRID grid.411903.e, Department of Health, Behavior and society, , Institute of health, Faculty of Public Health, Jimma University, ; P O Box: 378, Jimma, Ethiopia

[2 ]ISNI 0000 0001 2034 9160, GRID grid.411903.e, Department Population and Family health, Institute of health, Faculty of Public Health, , Jimma University, ; P O Box: 378, Jimma, Ethiopia

[3 ]ISNI 0000 0001 2182 2255, GRID grid.28046.38, Faculty of Health Sciences, , University of Ottawa, ; 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada

[4 ]ISNI 0000 0001 2182 2255, GRID grid.28046.38, Faculty of Medicine, School of Epidemiology and PublicHealth, , University of Ottawa, ; 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada

Article

Publisher ID: 334

DOI: 10.1186/s13690-019-0334-4

PMC ID: 6383212

PubMed ID: 30828451

SO-VID: 823736ab-5b91-4138-b992-c73f1d5538c4

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 22 August 2018

Date accepted : 23 January 2019

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ScienceOpen disciplines: Public health

Keywords: talking health,health messages,health messengers,ethiopia

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ScienceOpen disciplines: Public health

Keywords: talking health, health messages, health messengers, ethiopia

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Talking health: trusted health messengers and effective ways of delivering health messages for rural mothers in Southwest Ethiopia

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Electronic supplementary material

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Global Health Next Generation Network

Most cited references 10

Experiences with nutrition-related information during antenatal care of pregnant women of different ethnic backgrounds residing in the area of Oslo, Norway.

Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project

Contraceptive knowledge, attitude and practice among rural women.

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Cited by 15

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